Cardiac Cath Lab Activation for Subtle Acute Inferior STEMI

EMS responds to a 78 year old male complaining of chest pain. On initial observation the patient is pale, cool, and diaphoretic. He says to the treating paramedic, “I think I’m having a heart attack.” He states that he was watching TV when he felt a crushing pain that radiated to his arm and jaw. […]

February 11, 2016

ST-Segment Elevation in Elderly Patient Following Smoke Inhalation

EMS was dispatched to an 82-year-old female complaining of smoke inhalation following a fire originating in her clothes dryer. On arrival at scene the patient is conscious, alert, and anxious. She is being treated with high flow oxygen in the cabin of a fire engine. She has visible soot on her clothes, hands and face. […]

February 2, 2016

Cocaine Overdose Presents with Wide Complex Tachycardia

A 45 year old male with unknown medical history was taken into police custody under concern for trafficking illegal drugs. While he was in the back of the squad car he told the police he had swallowed a large amount of cocaine and may need to go to the hospital.  Not long afterwards he became […]

January 25, 2016

Shock, ST-Segment Elevation, and Massive Pulmonary Embolism

EMS was dispatched to a 48-year-old female having a seizure. As they walked into the residence the patient was laying on the couch, not responding to commands. Her carotid pulse was palpable but the radial was absent. She was noted to be cyanotic and breath sounds were clear. Side stream ETCO2 was placed under a […]

January 18, 2016

Acute Inferior STEMI with Right Ventricular Infarction and Cardiac Arrest

EMS (with physician on board) is dispatched to a 42-year-old male with a chief complaint of chest pain and “possible heart attack.” The patient is found lying on the couch. He appears to be reasonably comfortable and indicates that “the pain has eased a bit” since EMS was contacted. While the patient is being undressed […]

January 11, 2016